| NPI | 1952663288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101Y00000X Counselor |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2024-12-20 |